Michelle Lo

All Publications

• N2O Control of His Legs: Nitrous Oxide Toxicity Leading to Subacute Combined Degeneration Jain, V., Lo, M. American College of Physicians Northern California Regional Conference. Palo Alto, CA. 2023
• Right on Q Fever: A Case of Coxiella Burnetti Infection Presenting with Leukocytoclastic Vasculitis La, C., Lo, M. American College of Physicians Northern California Regional Conference. Palo Alto, CA. 2023
• Development and Evaluation of a Cognitive Aid Booklet for Use in Rapid Response Scenarios. Simulation in healthcare : journal of the Society for Simulation in Healthcare Mitchell, O. J., Lehr, A., Lo, M., Kam, L. M., Andriotis, A., Felner, K., Kaufman, B., Madeira, C. 2019; 14 (4): 217-222

  Abstract

  Rapid response teams (RRTs) have become ubiquitous among hospitals in North America, despite lack of robust evidence supporting their effectiveness. Many RRTs do not yet use cognitive aids during these high-stakes, low-frequency scenarios, and there are no standardized cognitive aids that are widely available for RRTs on medicine patients. We sought to design an emergency manual to improve resident performance in common RRT calls.Residents from the New York University School of Medicine Internal Medicine Residency Program were asked to volunteer for the study. The intervention group was provided with a 2-minute scripted informational session on cognitive aids as well as access to a cognitive aid booklet, which they were allowed to use during the simulation.Resident performance was recorded and scored by a physician who was blinded to the purpose of the study using a predefined scoring card. Residents in the intervention group performed significantly better in the simulated RRT, by overall score (mean score = 7.33/10 and 6.26/10, respectively, P = 0.02), and by performance on the two critical interventions, giving the correct dose of naloxone (89% and 39%, respectively, P < 0.001) and checking the patient's blood glucose level (93% and 52%, respectively, P = 0.001).In a simulated scenario of opiate overdose, internal medicine residents who used a cognitive aid performed better on critical tasks than those residents who did not have a cognitive aid. The use of an appropriately designed cognitive aid with sufficient education could improve performance in critical scenarios.

  View details for DOI 10.1097/SIH.0000000000000369

  View details for PubMedID 31116168

• Post-Transplant Lymphoproliferative Disorder: “More Than Meets The Eye” Lo, M., Villagomez, S. General Internal Medicine National Conference. Denver, CO. 2018
• Assessing and Improving Resident Stress During Rapid Response Scenarios American Thoracic Society International Conference Mitchell, O. 2018
• Voriconazole increases the risk for cutaneous squamous cell carcinoma after lung transplantation. Transplant international : official journal of the European Society for Organ Transplantation Kolaitis, N. A., Duffy, E., Zhang, A., Lo, M., Barba, D. T., Chen, M., Soriano, T., Hu, J., Nabili, V., Saggar, R., Sayah, D. M., DerHovanessian, A., Shino, M. Y., Lynch, J. P., Kubak, B. M., Ardehali, A., Ross, D. J., Belperio, J. A., Elashoff, D., Saggar, R., Weigt, S. S. 2017; 30 (1): 41-48

  Abstract

  Lung transplant recipients (LTR) are at high risk of cutaneous squamous cell carcinoma (SCC). Voriconazole exposure after lung transplant has recently been reported as a risk factor for SCC. We sought to study the relationship between fungal prophylaxis with voriconazole and the risk of SCC in sequential cohorts from a single center. We evaluated 400 adult LTR at UCLA between 7/1/2005 and 12/22/2012. On 7/1/2009, our center instituted a protocol switch from targeted to universal antifungal prophylaxis for at least 6 months post-transplant. Using Cox proportional hazards models, time to SCC was compared between targeted (N = 199) and universal (N = 201) prophylaxis cohorts. Cox models were also used to assess SCC risk as a function of time-dependent cumulative exposure to voriconazole and other antifungal agents. The risk of SCC was greater in the universal prophylaxis cohort (HR 2.02, P < 0.01). Voriconazole exposure was greater in the universal prophylaxis cohort, and the cumulative exposure to voriconazole was associated with SCC (HR 1.75, P < 0.01), even after adjustment for other important SCC risk factors. Voriconazole did not increase the risk of advanced tumors. Exposure to other antifungal agents was not associated with SCC. Voriconazole should be used cautiously in this population.

  View details for DOI 10.1111/tri.12865

  View details for PubMedID 27678492

• A Sticky Situation: Hypermucoviscous Klebsiella pneumonia causing alternative pyogenic abscess Lo, M., Cowley, A., Wei, D. Society of General Internal Medicine National Conference. Washington D.C.. 2017
• Lung Transplant Outcomes in Systemic Sclerosis with Significant Esophageal Dysfunction. A Comprehensive Single-Center Experience. Annals of the American Thoracic Society Miele, C. H., Schwab, K., Saggar, R., Duffy, E., Elashoff, D., Tseng, C. H., Weigt, S., Charan, D., Abtin, F., Johannes, J., Derhovanessian, A., Conklin, J., Ghassemi, K., Khanna, D., Siddiqui, O., Ardehali, A., Hunter, C., Kwon, M., Biniwale, R., Lo, M., Volkmann, E., Torres Barba, D., Belperio, J. A., Sayah, D., Mahrer, T., Furst, D. E., Kafaja, S., Clements, P., Shino, M., Gregson, A., Kubak, B., Lynch, J. P., Ross, D., Saggar, R. 2016; 13 (6): 793-802

  Abstract

  Consideration of lung transplantation in patients with systemic sclerosis (SSc) remains guarded, often due to the concern for esophageal dysfunction and the associated potential for allograft injury and suboptimal post-lung transplantation outcomes.The purpose of this study was to systematically report our single-center experience regarding lung transplantation in the setting of SSc, with a particular focus on esophageal dysfunction.We retrospectively reviewed all lung transplants at our center from January 1, 2000 through August 31, 2012 (n = 562), comparing the SSc group (n = 35) to the following lung transplant diagnostic subsets: all non-SSc (n = 527), non-SSc diffuse fibrotic lung disease (n = 264), and a non-SSc matched group (n = 109). We evaluated post-lung transplant outcomes, including survival, primary graft dysfunction, acute rejection, bronchiolitis obliterans syndrome, and microbiology of respiratory isolates. In addition, we defined severe esophageal dysfunction using esophageal manometry and esophageal morphometry criteria on the basis of chest computed tomography images. For patients with SSc referred for lung transplant but subsequently denied (n = 36), we queried the reason(s) for denial with respect to the concern for esophageal dysfunction.The 1-, 3-, and 5-year post-lung transplant survival for SSc was 94, 77, and 70%, respectively, and similar to the other groups. The remaining post-lung transplant outcomes evaluated were also similar between SSc and the other groups. Approximately 60% of the SSc group had severe esophageal dysfunction. Pre-lung transplant chest computed tomography imaging demonstrated significantly abnormal esophageal morphometry for SSc when compared with the matched group. Importantly, esophageal dysfunction was the sole reason for lung transplant denial in a single case.Relative to other lung transplant indications, our SSc group experienced comparable survival, primary graft dysfunction, acute rejection, bronchiolitis obliterans syndrome, and microbiology of respiratory isolates, despite the high prevalence of severe esophageal dysfunction. Esophageal dysfunction rarely precluded active listing for lung transplantation.

  View details for DOI 10.1513/AnnalsATS.201512-806OC

  View details for PubMedID 27078625

  View details for PubMedCentralID PMC5461989